Why does Mass. have highest health premiums?

Why does Mass. have highest health premiums?


Massachusetts has the highest family health insurance premiums in the country, which some pundits claim is the reason we need national universal health care, aka Obamacare. I say that it’s the result of the state’s universal health care plan on which Obamacare is based in concept. Commonwealth Care, aka CommieCare, they say, was passed first to provide universal access and cost controls would come later.

Great. Government-mandated cost controls always work out so well. How about breaking down the barriers to competition, allowing the thousands of providers who can only now compete within their own states to sell insurance in any state? How about letting companies and their employees figure out what coverage to carry instead of mandating all kinds of fringe and/or objectionable procedures like transgender mutilations, sterilizations, contraception, et al?

Part of the problem is that there hasn’t been a secondary market for medical care, i.e. walk-in clinics. If you get sick, you either try to get an emergency appointment with your primary care physician, always a dicey proposition, or you make an expensive emergency room visit. As I said in a previous post, when we took Sophia to her pediatrician when she had nursemaid’s elbow, we saw the doctor for 2 minutes, we paid $15 for a co-payment, and insurance got billed $165. For 2 minutes. If we’d gone to a clinic, it might have cost considerably less.

Because the consumer is not involved in the cost consideration relationship, there is no incentive to avoid costly procedures or to mitigate costs of any kind. So we end up with insurers looking for ways to deny claims, even valid claims, as a way to control their expenses. This leads to the dysfunctional system we have now.

More government regulation in the form of universal health care doesn’t solve the problem. Less regulation would. When the CVS pharmacy chain proposed opening medical clinics in its stores in Boston, the mayor actually made the claim that it’s wrong to make a profit off of sick people. Really? Because that’s the whole premise of the health-care industry. Do we really want to give these politicians more control over our health care? (Of course, it couldn’t be that all of the very wealthy doctors and hospitals and medical industry that make up a large part of Boston’s economic base—and thus political lobbying power—would be opposed to the competition, could it?)


  • Eh—

    The data in the article don’t show that big a difference between MA and the rest of the country. 

    That five-year difference in premium hikes (40% vs 33%) works out to a 7%-per-year inflation in MA vs. 6%-per-year in the US.  So the difference is something, but not enormous.

    I’m a beneficiary of the change in MA: insurers are required to offer individuals the same rate they offer to small groups of 2-10, and when the law took effect, individual rates plummeted. 

    Under the old system, I paid for employer-based insurance that cost $650/mo. (under COBRA), and individual rates were higher than those.  Some companies simply didn’t offer individual policies. 

    Afterward, I got a BCBS individual plan for $400/mo.  And that’s not with a subsidy; it’s just a result of this regulation that created a market for individual insurance.

  • So CommieCare at least benefited somebody. That’s good to know. Of course, the bureaucracy it created is itself bloated and inefficient and there are other effects on the insurers and the industry and some of the insured that are still shaking out. And small business owners and those who want to be uninsured are suffering as well.

  • Do you really know how the current Mass. health-insurance system works?  I’m a little uncertain since you don’t seem to be using the name of the program correctly.

    “Commonwealth Care” is only the subsidized part of the system; it is, in effect, a state replacement for the old Medicaid system.  (State initiatives and local experimentation are not a bad thing, from the POV of subsidiarity.)  The MassHealth agency that runs it may be efficient or inefficient (I’m guessing the latter), but it’s been here all along, so that’s nothing new.

    Either way, it isn’t directly involved with your experience with the pediatrician, and it isn’t directly involved with families who get insurance through their employers—which is what the Globe article is about.  So I don’t think you’ve made a strong enough logical case for your point. 

    If I may characterize your objection, it seems to be a fairly standard libertarian grumble.  But libertarianism, if I understand it aright, is a secular individualistic ideology, so I’m not that enthusiastic about it.

  • I have a health insurance policy in a southern state. It’s $200 a month. It’s Blue Cross/Blue Shield, I’ve never had an issue, I’m comfortable with the coverage. I do NOT want the government coming in with mandates for coverage that will drive my insurance costs up. If anything, I want health insurance to become mroe like auto insurance, and offer even more choice, with just a few mandated things (Like catastrophic, equivalent of collision for autos.)